Duke University Medical Center has been engaged in the training of clinicians and scientists in the area of cardiovascular diseases for over 50 years. The philosophy has been to integrate training and research by creating an environment that facilitates the natural linkages among programs and departments throughout the University. By any measure, the program has succeeded in training a generation of outstanding investigators who are now prominent teachers and leaders in academic medicine. Much of this success can be attributed to 34 years of funding of the Cardiovascular Training Program Grant. Our goal is to maintain this history of productivity by creating an environment that will ensure that Duke will continue to contribute to the development of young investigators capable of pursuing successful research careers in cardiovascular fields. Since the last competing renewal, the PI has implemented a number of substantial changes to our program in an effort to significantly enhance the educational and research experience of our trainees. Some examples of changes that have been made to our program include: 1) Didactic course work during research fellowship that can lead to a Masters Degree from the School of Medicine, 2) Weekly seminar series on grant writing and mentoring in the summer of each year, 3) Requirement that all trainees apply for extramural funding for a Postdoctoral Research Grant in the second year of Cardiology Fellowship, 4) Biannual written evaluations of mentors by trainees, 5) Biannual written evaluations of trainees by mentors, 6) Year-end Research Symposium for fellows, with awards for the best abstract presentation, 7) Regular basic science research conferences given by program faculty to all cardiology trainees, 8) Creation of a two- month basic science elective during the first year of the clinical fellowship program for all fellows as an introduction to the basic sciences, and 9) New format to our Monthly Research Conference that integrates clinical and basic research on a thematic basis, and which provides a forum where trainees learn how to translate findings freely between the basic and clinical spheres. The goal of this program is to continue our training of talented Physician-Scientists by creating an environment that will ensure the development of our young trainees into highly successful and innovative independent investigators.